The First Five Chapters of Running Still
When Jack heard the diagnosis, he refused to believe it. The doctor’s next words made it to his ears, but they didn’t register. Everything from that moment on was just noise.
Cancer. Invasive. Aggressive. Terminal. Again.
He vaguely heard the doctor mumbling about advanced treatments, experimental drugs, and survival percentages, but none of it registered. This was the third time Jack sat in the same chair, in the same office, listening to the same doctor speak the same words. His shoulders sagged as he let out a deep breath. He had feared the worst, and now the nightmare became real.
"How is this possible?" Jack managed to utter.
"Sometimes it just runs in the family...,"the doctor began.
“But it DOESN’T run in the family!" Jack shouted, before the doctor could finish his thought. “Not mine, and not hers!" He jerked a thumb in his wife’s direction. Amy, sitting in the chair next to him, put a hand on Jack’s arm in a futile attempt to calm him.
They’d been married for sixteen years and for the first fifteen it had been idyllic. They met in college, his fourth year, her second. Jack was a scholarship athlete, a distance runner. He was a great runner, but not elite. He had never won a race, not in high school, and not in college. There always seemed to be someone faster. He was second best in high school, and ranked fourth among Division I college runners. Some said it was just bad luck, others poor timing.
One day, during a training run, he slipped on a wet track and scraped his knee badly on the rough surface. Amy was the assistant team trainer who patched him up. There was an instant attraction, and the relationship blossomed quickly. They dated for just under two years before tying the knot, right after she graduated with a degree in Alternative and Complementary Medicine.
Jack’s degree was in Sports Science, though his primary focus coming out of school was running. While Amy studied and went to class, Jack ran. He had hoped one day to figure out how to make money at it, to make a career out of running, or coaching, or both. But none of that was going to happen.
In addition to running, Jack also worked part-time with a locksmith, a teammate’s uncle nice enough to give him a job. Jack liked it mainly because of the flexible hours. It allowed him the freedom to run when he wanted and work when he felt like it. He was a good worker, picked up some skills, and learned what he needed to do the job. When he wasn’t at the shop, he was focused on his endurance and speed.
Shortly after the wedding, Amy got pregnant. She often joked that when the baby kicked, it was really running laps around her uterus. Emma was born just before their one-year anniversary. Two years later came Nate. With a boy and a girl, both happy and healthy, Amy declared the ‘factory closed’. Emma was running practically before she could walk. Nate did everything he could to keep up with his big sister.
They were a postcard family. Healthy, attractive, fit… everything an American family could hope to be. They exercised together, ate dinner together every night, read together, and Jack and Amy were always there to tuck the kids in at night.
"Jack, are you hearing me?” the doctor asked, interrupting his thoughts.
“I hear you Dr. Holst, but I don’t understand,"Jack said, exasperated. “How is this possible?” Jack was on his feet now, pacing around the office. “How can three people from the same family, two of them KIDS, have cancer?! All diagnosed within a year! Amy and I never smoked, we never did drugs, we don’t drink, we eat healthy, we exercise, we drink nothing but water… it doesn’t make sense!”
“I know you're upset. But you’re not alone, Jack. I have other patients with this same cancer," Dr. Holst submitted, instantly regretting the words.
Jack stopped pacing, turned to face Dr. Holst and said, a little too loudly, “Is that supposed to make me feel better?! You just told me my son, my twelve-year-old son, is going to die from cancer. First Amy, then Emma, and now Nate. I’m going to lose my whole family to this shit, and I’m supposed to feel better because other people get cancer too?! Is that what you’re saying?”
Dr. Holst was all too familiar with the emotional outbursts that often happened in these types of meetings. He took a breath and replied calmly, “We don’t know that any of them are going to die, Jack. So far, the new medication seems to be working for Amy and Emma. We’ll get Nate started on it as soon as all of his tests are complete."
Jack loaded another retort, but before he could fire it off, Amy stated calmly, “Jack, sit down. This isn’t helping."
Jack grudgingly plopped back into his chair. He always bent to Amy’s will, now more than ever. He didn’t know how much longer he would have with her, and upsetting her was the last thing he wanted to do. He looked at her and offered a weak smile. “Sorry," he muttered.
“I know how you must be feeling," Dr. Holst began. Jack whipped his head around and focused his intense gaze on the doctor. Realizing his poor choice of words, Dr. Holst moved on. “We’ve talked about this. Sometimes genetics play a role in these things, and there’s nothing we can do."
“Dr. Holst,” Jack said calmly as his wife gently squeezed his hand, “Amy and I have subjected ourselves to every genetic test you requested. We went to the experts YOU recommended.” Jack made air quotes with his hands around the word experts. “The tests found nothing. No tumor markers, no genetic alterations, nothing. We have no family history of ANY kind, certainly not life-threatening cancer. Our parents are still alive and in good health. Our grandparents lived well into their 90s. Our family is the picture of health. Or was.”
Suddenly Amy was up from her seat, moving quickly to the side of Dr. Holst’s desk. She doubled over and began to vomit into his garbage can. Jack was immediately at her side rubbing her back, speaking comforting words and trying to convince her (and himself) that it was going to be ok. He looked up, locked eyes with the doctor and said softly, “What is happening to my family?”
“Hey, Lisa? What am I looking at here?”
Dr. Arush Patel was the head of clinical pathology at the BSC Medical Center in Chicago. His office was responsible for analyzing blood and tissue samples for Chicago and the surrounding areas. He sat on a stool with his head down and his eyes focused through the oculars of his microscope. He was fascinated by what he saw. Fascinated and horrified. The cells on the slide were over-sized and irregularly shaped, and they were often clumped together abnormally.
“There’s virtually no normal tissue here," he said, more to himself than anyone else. “Lisa?”
“Yes, Dr. Patel."
He picked his head up and turned to look at his lab assistant. “Is this the same slide as yesterday?”
“No, Doctor. This is a different patient. That sample came in last night.”
He paused for a moment before saying, “This is a different patient from yesterday?" not sure he was hearing her correctly.
He shook his head. “Let me see the paperwork.” She walked over to her desk, leafed through some files, and then brought the appropriate paperwork to him. He matched the file number on the folder to the number on the vials before opening it. He scanned the paperwork inside, and then looked up.
“This patient is fourteen years old," he said. His voice was low and his words were soft, as if he could somehow keep them from being true.
Lisa moved to stand next to him and looked into the open file.
“Yes, sir," she said, pointing at the date of birth. “Why, what is it?”
“It’s the same cancer again." He scratched his head, and asked, “How many is that now?”
“I’m not sure, Dr. Patel. I’d have to check. But that’s at least five this week.”
“Five this week," he repeated in disbelief. “Overall. Give me your best guess, Lisa."
“Since we started seeing samples like this? Must be a hundred by now."
Dr. Patel sat back down on his stool. The open folder rested in his hand on his lap as he stared out into space. Just over a year ago, he began seeing strange cancer cells appearing in blood samples and biopsies. At first, he thought it was just an anomaly. Some rare cancer rearing its ugly head. But they kept coming. The samples slowly trickled in, but recently he began seeing more of them. More and more samples revealing the same disease. And now he would have to write a pathology report confirming that a fourteen-year-old had late-stage cancer.
“What is going on here?" he asked.
The sound of the pavement under his feet was almost therapeutic. After years of running and thousands of miles, Jack could still find solace in a long run. Today, however, was different. His body was running, but his mind was racing. How could this be happening? His whole family was dying. Why? He refused to believe it 'just happens’, despite what Dr. Holst said. Things like this don’t just happen. They passed every genetic test they’d been subjected to. They were borderline neurotic about what they ate. No processed foods. No high fructose corn syrup. No GMOs. They ate only organic. They were vegetarian. And they only drank water. No soda or other sugary drinks.
As the scenery passed in a blur, Jack’s mind continued to wander. He’d run this route hundreds of times, he could do it blindfolded. He paid no attention to the buildings he ran past, the turns he made, not even the ground under his feet. It was late at night, so he had the streets to himself. That’s how he liked it. Dark, cool and quiet. Alone with his thoughts was usually a good thing, but not today. Not in a while. Not since Amy got sick. Then Emma. And now Nate. He tried to fight the emotion that was welling up inside him, but a few tears managed to find their way down his face.
He’d cried a lot over the last year, especially in the beginning. Recently, though, his feelings had changed from sadness to anger. This was new for Jack. He was raised in a happy home, the youngest of three boys. And while his older brothers picked on him now and then, it was the usual brotherly horseplay. They always had his back. No one else dared pick on him, and Jack never invited it from others. He was a kind kid, not a mean bone in his body. He’d never been in a fight his whole life. Not even with his brothers. Sure, they’d push and shove and wrestle around, but it was always half-hearted, never with any anger behind it. Jack never had any reason to be angry. Until now.
Jack pushed his lean frame a little harder as he ran towards the lake. He had reached the outskirts of town and the wind picked up a little. As he saw his rippled reflection in the edge of the water, the question he’d been avoiding came back. Why wasn’t he sick? His wife, his daughter, and now his son. Why? And why not him?
If it truly was genetics, like Dr. Holst was pushing them to believe, it would be from Amy’s side of the family. That would explain why it was affecting her and the kids, but not Jack. But they thoroughly investigated her family tree and couldn’t find anyone who had cancer. Her parents were still alive and well, and her grandparents lived long, full lives. No aunts, no uncles, no distant cousins. Nothing. Jack’s family history was equally unremarkable. And it couldn’t be a recessive gene. It takes both parents to contribute that for it to appear in their children.
“Maybe spontaneous mutation," Dr. Holst and the other specialists had postulated. The way it had been explained, it’s possible for a genetic sequence to experience a sudden change, or mutation, without any known cause. So no rhyme or reason. Just a natural mutation. But these are rare, and Jack found it hard to believe Amy could have experienced a spontaneous mutation after thirty-seven years of life, and shared that genetic anomaly with both kids. It didn’t add up. The doctors wanted to agree, but since they had no other ideas, they stuck with it as the most plausible explanation.
Jack started thinking about external factors, food being the likeliest of suspects. But if it was something Amy and the kids had been eating, wouldn’t it affect Jack also? They all ate the same stuff. But how could it be from food, Jack wondered. He and Amy had eaten clean for years, and the kids followed suit. They’d been disciplined regarding their diet, mainly to avoid this exact situation. Amy always railed against the food industry and how they’ve been poisoning people for years. Nearly 60% of Americans are taking prescription drugs, largely because of their poor diets. She recited the statistics all the time. She learned all kinds of scary numbers while studying for her Alternative and Complementary Medicine degree. Amy was the main reason they ate as clean as they did. When Jack was in college, he was running so much, burning so many calories, he ate whatever he wanted. He was lean and trim, regardless of what he put in his mouth. He couldn’t gain weight even if he had wanted to. But over time, Amy helped him understand how much diet matters, both in performance and long term health.
No, Jack thought. It couldn’t be their diet. Short of growing their own food (which they had discussed more than once), they’d done everything right. Or so they thought. Maybe the food they’d been eating wasn’t so safe after all. They’d read plenty of commentary on the world of organic food. It was big business, and some believed there was NO way a farmer could grow entire crops of food without using a single drop of pesticide. The amount of crop loss to insects, animals, weeds, etc. would be staggering and would dramatically eat into the farmer’s profits.
During her final semester while she worked on her thesis, Amy learned that most organic farmers DO use pesticides. But instead of chemical or synthetic pesticides, they’re ‘natural’. They’re still designed to kill bugs and protect the crops, but the natural version isn’t as effective, so farmers actually wind up using more of it. And because they’re studied less, scientists know little about the potential side effects they may have.
As Jack rounded the lake to head back, he made a mental note to look deeper into what they were eating. But for the return run, he decided to focus on other things. Clear his head. On the run out, he was oblivious to everything around him. Now he noticed everything. He looked up at the stars, spotted Orion’s belt. He watched the trees go by, counted them. He passed an old warehouse that, judging by all the broken windows and rusty panels, had been abandoned for years. He ran by the tall fences that surrounded the town’s water treatment plant. As he approached the edge of town, he spotted the local radio station. He wondered if the folks on the other side of town got good reception. The town offered more distractions for him as he ran. He enjoyed the architecture, the simplicity of the buildings. He ran past the local stores, many of which he knew well, some he’d never visited. He used to think there would be plenty of time. Now he wasn’t so sure.
“Whadda we got?" Detective Mercer asked. It was early evening and the sun had just begun to set. He stood on the north bank of the Chicago river, just inside the yellow police tape. He was surrounded by fellow police officers, EMTs, and two assistants from the Cook County Medical Examiner’s office. Lights were being set up and a small crowd was beginning to form.
“We got a floater," Officer Blake said. He pointed to the gurney parked ten feet away, near the ambulance. “Two joggers found that guy floating face down about an hour ago."
“We got an ID?" Detective Mercer asked.
“His driver’s license says his name is Arush Patel."
“His driver’s license?”
“Yep. His wallet was still in his back pocket. All the credit cards were still in it, even some cash," said Officer Blake.
“So whoever did this clearly wasn’t interested in money. What do we know about Mr. Patel?" asked Detective Mercer.
“It’s Dr. Patel," Officer Blake replied. He took out a small notepad from his pocket and referred to his notes. “Apparently he was some kind of pathologist here in Chicago. Worked for the BSC Medical Center for the last eleven years. Originally from India, he came here as a college student and liked it so much, he decided to stick around. Northwestern University for undergrad, medical school at the Feinberg School of Medicine, then Northwestern."
“Impressive," Detective Mercer said. “And how did Dr. Patel wind up face down in the Chicago River?”
“We don’t know that yet, Detective. But according to his office, he had no enemies. He was a real sweetheart."
“Well clearly someone didn’t think so. Did his office have anything helpful to contribute to the investigation?”
“Not really," Officer Blake replied. “According to his lab assistant, he spent the last hour of the day talking on the phone.”
“Who was he talking to?" inquired Detective Mercer.
"She said he made several calls. The first few were to other doctors. I have their names and numbers. But his longest call was to the Centers for Disease Control and Prevention."
“The CDC? What’s that all about?”
“Honestly, it was kinda confusing. She was speaking a little above my pay grade. But it had something to do with a new cancer they’d been seeing a lot of lately."
Her flight landed shortly before nine p.m. Every time she came back, Cheryl forgot about the cute little airport with only one terminal. The one with no shops, no news stand, no Cinnabon, not even a Starbucks. The one where big commercial planes can’t land. She hated flying as it is, but the puddle-jumper prop plane she was forced to take on the last leg of the trip added new dimensions to her loathing. She’d thrown up on it twice in the past, but managed to keep her dinner down this time. Cheryl walked down the few steps from the plane onto the tarmac, and let out a deep breath, grateful to be on solid ground once again.
Looking around, she couldn’t help but smile. She had always likened her home town to Mayberry, and it didn’t take long for all the memories to come rushing back. Earlier in the day, she was fighting through the crowded terminals of JFK airport in New York. A packed flight that landed in Atlanta, another airport overflowing with travelers. A few hours later, she was in the Twilight Zone. But she loved her sister, and adored her niece, so it was all worth it. Plus, they needed her now.
She rolled her carry-on across the tarmac and into the deserted terminal. Other than one person at the ticket/baggage/lost luggage/customer service counter, Cheryl had the place to herself. She walked by the lone vending machine. It was the kind that still took change, actual coins, and required you to pull the little handle out to get your chosen item. She shook her head as she made her way through the sliding glass doors and out front.
Cheryl always expected Barney Fife or Andy Griffith to be parked at the curb when she emerged, but they never were. Her sister, however, was there, standing next to her 1988 Ford Explorer. The same car she’d been driving for at least ten years. Cheryl had lost count. Brenda was five years younger than Cheryl, but she looked ten years older. When she first got sick, they both refused to believe it. Cheryl flew home the same day and, together, the two sisters cried. Cancer was the last thing she was expecting to hear. Brenda had smoked on and off as a teenager and early into her twenties, but she kicked the habit years ago, when she first got pregnant. She suffered a miscarriage in her first pregnancy, and though it was not smoking related, she never lit up again. Brenda was five feet three inches tall and about fifteen pounds overweight, but overall in good health. So it was a shock when she called Cheryl to break the news.
Her doctor had started her on traditional therapy right away. Chemo, radiation, the works. But when her cancer was deemed ‘too aggressive’ for traditional methods, her doctor recommended a new medication that had recently become available to the public. Because her cancer was unresponsive to the standard treatments, her doctor fought for Brenda and made sure the insurance company paid what they were responsible for. The new drug slowed the progression of her disease, and her doctor was happy. But her long term prognosis was still not good. ‘Terminal’ is what Brenda had been told, but the timetable was unclear. That was just under a year ago.
Cheryl managed a weak smile as she walked up to Brenda. She parked her rolling suitcase at the curb and hugged her little sister. Cheryl was five inches taller and enveloped Brenda like a parent does a child. She felt Brenda begin to sob and hugged her even harder.
“You doin’ ok?” Cheryl asked softly.
“Not really, “ Brenda replied through the sniffles. After a while, they released each other and Brenda looked up at her sister’s sympathetic face. “I’m trying to be strong,” Brenda said, “for Lily’s sake. But I haven’t figured out how to tell her.”
“What does she know so far?" Cheryl asked.
“Just that she’s sick, like me. She doesn't know how bad it is. I never told her. How in the world am I supposed to tell her this?”
Cheryl touched her sister’s face. She had no words. After a brief silence, Brenda trudged around to the other side of the car and got in the driver’s seat. Cheryl threw her bag in the back and jumped into the passenger seat. The door creaked as she closed it and for a second she was afraid it would fall off.
Brenda started the car and, as they pulled away from the curb, Cheryl asked, “Did you call the specialist like we talked about?”
“I can’t afford it, you know that. Our doctor here seemed pretty sure of what’s going on. He said Lily’s blood test came back the same as mine.” Brenda’s eyes started to water again, and Cheryl wanted to change the subject. But there was no getting away from this. No matter what they talked about, it would always be in the front of their minds.
“She really needs to see the specialist, Brenda. Maybe they’re wrong, maybe they…”
“They’re not wrong!” Brenda exploded. “Lily is gonna die and there’s nothing I can do to save her!” Tears streamed down her face as she wept. The airport was in a remote stretch of town and the streets were basically empty, so Cheryl wasn’t worried about them hitting anything or anyone. Let her cry, she thought.
When they came to a red light, Cheryl reached over, put her hand on Brenda’s arm and said “I’m so sorry, Brenda.” She couldn’t imagine what her sister was going through. Facing your own death is hard enough. But when it’s your child, it must be devastating. Lily was all Brenda had. Her husband left shortly after she got pregnant with Lily, and hadn’t been heard from since. It was no great loss. He hadn’t worked in a year and a half and was not qualified to do much.
Brenda was an assistant information security officer for U.S. Ally Security, a national security company that provides everything from security systems to security guards to cyber-security. Their clients were typically large companies and corporations with hundreds or thousands of employees, with a ton of data to protect. U.S. Ally Security had monitoring stations and server warehouses all over the country. They protected financial information, product information, employee information, customer information, and so on. Research indicated that small town workers were more willing to accept lower wages, so many of their monitoring stations were placed in low population communities. It certainly wasn’t glamorous work, but it was a good job. And the benefits, including and especially health care, were excellent.
Cheryl never had kids. She was a career woman, or hoped to be. When she moved to New York seven years ago, she vowed to stay single until her career was in full swing. She took an internship at the New York Journal, with a goal of being an investigative reporter. But so far, she’d spent most of her time fact checking and doing research. She had submitted a number of articles to her editor, only to have them rejected for not having ‘enough teeth’, whatever that meant. She knew, one day, her work would make a difference.
They pulled up to Brenda’s two-bedroom house, and Cheryl thought she might wake the whole neighborhood as the rusty door of the Explorer loudly squeaked its way open. Inside, the house was quiet. Lily had already gone to bed, and the sitter was on the couch half-asleep herself. She stirred as the two came in. Brenda made quick introductions and they exchanged quick hellos. By Cheryl’s estimate, Tanya, the sitter, couldn’t have been more than sixteen. She wore blue jeans, white sneakers, and a dark hoodie.
“How did she do?," Brenda asked.
“Ok, I guess," Tanya said with shrug. “She was pretty tired, so she went to bed not long after you left."
“It’s the new medicine. It makes you tired, especially in the beginning.” Tanya nodded, not knowing what else to say.
“Did she throw up?"
“No, she was ok," Tanya said.
“Good," Brenda said, relieved.
Once paid, Tanya added, “Call me if you need me," and left quietly.
Cheryl rolled her bag into the den. The pull out couch against the wall would be her bed for the next several nights. She came out into the kitchen as Brenda was tossing back a couple of pills with some water.
“I just reminded myself," she said.
“What was that?” Cheryl asked.
“The cancer drug. They just started Lily on it too. I’m supposed to take it twice a day, but sometimes I forget mine when I’m busy dealing with her.”
Cheryl gave her a look.
“I know, ok. But Lily has been a handful recently. She’s tired, nauseous, cranky, irritable, sad…." Brenda started to tear up again. “It’s just not fair," she whimpered. “Why her?”
“Brenda, I know this is hard, but Lily really needs to see a specialist. I’ll help in any way I can. We’ll make it work. But these small town doctors can’t handle this. Are they even up on the latest research, the newest methods? Have they ever had to deal with anything like this? This is not a scraped knee or runny nose.”
“I know, Cheryl," Brenda snapped. “Don’t you think I know that? But I don’t have the money to pay a specialist, and neither do you, for that matter! I’ve already spent most of our savings on the medication, and now we both need it. The insurance company covers a lot of it, thank god, but I’m still responsible for the rest. And it’s expensive.”
“But the doctor…” Cheryl began before Brenda cut her off again.
“Dr. Bosh is a good doctor. He’s been managing my case for almost a year and I’m still here. When he first discovered my disease, he said he consulted with a specialist up north. In New York, I think. That’s how he found out about the medication we’re taking. He even helped us get it covered by our insurance. I trust him. Besides, he said there are other families in town with the same type of cancer, so he knows what he’s doing.”
“Wait, what? What do you mean other families? What does that mean?”
“I don’t know. He said he’s seen a few other cases like ours. Other people sick like us.”
“Other families...with terminal cancer? In this town?” Cheryl spoke slowly, not sure she believed what she was hearing. She couldn’t fathom how a town with a population of just over fourteen hundred could produce multiple cases of the same cancer, let alone two in the same household. “How many?!”
“I don’t know!" Brenda answered, exasperated. “How am I supposed to know that, Cheryl? I have my own problems, ok? What does it even matter?”
Excerpted from Running Still by Steven Sheiner. Copyright © 2017. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the author or publisher.